Three Essays on Mental Health Courts

Author

Taylor E. Le Moal, Clemson UniversityFollow

Date of Award

8-2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Policy Studies

Committee Chair/Advisor

Lori Dickes

Committee Member

Devon Gorry

Committee Member

Thomas Hazlett

Committee Member

Michael Makowsky

Abstract

Mental illness in the criminal justice system is a major issue, with 2 in 5 incarcerated people in the US having a serious mental illness (Criminalization of People with Mental Illness, n.d.). Prisons have turned into “de facto” mental health facilities when these facilities are not equipped to do so. This means once individuals are released from incarceration, they are often ill-equipped to return to regular life and may get caught up in the cycle of recidivism (Slate, 2017). One method that policymakers have used to solve this problem is mental health courts (MHCs), which are pre-trial diversion programs that provide an alternative to incarceration for people with mental illnesses and connect people with treatment providers and community resources, with the goal of breaking the cycle of recidivism and improving access to mental health services.

To study the effectiveness of these courts and how counties decide to adopt these courts, this research used both qualitative and quantitative methods. Semi-structured interviews and document reviews of four counties in Virginia and South Carolina were used to study what barriers and facilitators counties face when they establish and operate a mental health court. The thematic analysis found that the main facilitator for success was people, both court employees and community employees, working together for the good of the mission, while the main barrier to success was the lack of resources. The interviewed courts showed success in many different facets, such as reduced recidivism, financial savings, and increased access to treatment. To study which policy diffusion mechanism was most important for counties deciding to adopt MHCs, a probit regression was run to measure the likelihood of a county establishing an MHC. The regression shows that the learning mechanism had the largest effect on counties considering MHCs. To study how effective mental health courts are at reducing crime rates nationally, a panel event study was used, comparing crime rates for crimes against property, society, persons, and other crimes before and after mental health court adoption. The results show that there were no significant changes in crime pre- and post-MHC adoption for any type of crime.

Recommended Citation

Le Moal, Taylor E., "Three Essays on Mental Health Courts" (2025). All Dissertations. 4085.
https://open.clemson.edu/all_dissertations/4085

Author ORCID Identifier

0009-0009-2495-3969